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Our World — 4 April 2009

MUSIC: "Our World" theme

This week on Our World: Could a five-in-one pill help prevent heart attacks? ... One of the first digital encyclopedias calls it quits... and the role of agriculture in fighting climate change ...

GERALD NELSON: "Change crop mixes, use cultivation systems that leave residues, shift land use from annual crops to perennial crops or to pasture or to agriforestry."

Those stories, a first look at America's next manned spacecraft, a new book to help fight diabetes, and more.

I'm Art Chimes. Welcome to VOA's science and technology magazine, "Our World."

5-in-1 'polypill' reduces heart disease risk factors

Researchers reported in the journal Science this week that heart muscle cells are replaced over a person's lifetime.

Previously, the conventional wisdom had been that the heart cells we're born with are the heart cells we keep. But scientists in Sweden, France, and the U.S. found that about half the heart cells are replaced over a normal lifetime.

The discovery opens up the possibility of growing new cells to replace the ones killed during a heart attack.

Of course, it's better to prevent a heart attack than to repair the damage, which is why another study published this week caught our eye.

This one suggests that combining several medicines in one pill may be an effective way to reduce heart attacks and strokes.

The so-called "polypill" or "polycap" combines aspirin, a statin drug to lower cholesterol, and three blood pressure medicines.

All these medicines are known to lower the risk of heart attacks and strokes, but Dr. Koon Teo of McMaster University in Canada says it's difficult to get seemingly healthy people to take a bunch of drugs every day.

TEO: "Especially if they feel good, they say, why do I have to take all these pills? You mean for the rest of my life? And of course, if they don't take the pills, they don't get the benefit. So we thought, well, if we can manage to put five or four medications into a pill, then it simplifies the process. They will only take one pill a day. And that's it."

Dr. Teo is one of the researchers behind the study, which was published online this week by the British medical journal, The Lancet, and presented this week at a meeting of the American College of Cardiology.

The study involved 2,000 middle-aged men and women in India. It found that the polypill was successful in lowering blood pressure and cholesterol without many side effects. In fact, subjects experienced fewer side effects from taking the polypill than they did from taking the drugs individually. But Teo says they'll need to do more extensive tests to see if the polypill actually reduces cardiovascular illness and death, not just the risk factors that can lead to heart disease:

"We need to prove it in a bigger population and for longer, so that we can actually see the effects of this polypill in reducing heart attacks and strokes."

The study was funded by the Indian company which is developing the polypill, Cadila Pharmaceuticals.

If successful, the polypill would likely be available in just a few standard doses. Patients with more complex needs would still probably have to take individual drugs. But the hope is that an inexpensive, standard polypill could help many people reduce their risk of heart attack and stroke.

Christopher Cannon is a cardiologist at Brigham and Women's Hospital in Boston and is the author of a commentary that accompanied the research paper. He stresses that taking cholesterol or blood pressure medicine doesn't give people license to eat unhealthy foods or avoid exercise.

CANNON: "That actually is a very big worry. We're continuing to say that we really need both — a healthy life style and medication when it fits in to help treat the risk factors."

Heart disease is the world's number one cause of death, and Dr. Cannon says it's no longer a disease mainly of Western industrial countries.

CANNON: "Well, unfortunately the problem is now growing around the world, and this is tracking with the so-called Western diet that is not very healthy, and the consequent increase in obesity or being overweight, and these are the risk factors that track with that. And so people start to pick up more and more risk factors for heart disease."

In his commentary, Dr. Cannon says the simplicity and presumed low cost of the polypill would be particularly well-suited to areas with less access to medical care. But both he and Dr. Teo say it also might make it easy for patients in richer countries to protect themselves without having to take a handful of pills every day.

Study suggests improved way to fight cholera

Zimbabwe has been battling a cholera epidemic, which has killed more than 4,000 people since the outbreak began last August.

Cholera is a chronic problem throughout the developing world, primarily in areas where sanitation is poor and intestinal parasites are common. Now, new research suggests that these parasites could be reducing people's ability to resist cholera infection, and reducing the effectiveness of the cholera vaccine. Véronique LaCapra reports.

LaCAPRA: Cholera is a bacterial infection that affects millions of people worldwide. They get the disease by eating food or drinking water contaminated with cholera bacteria, often from the feces of an infected person.

Cholera can cause severe diarrhea, vomiting and dehydration, which can be fatal if left untreated.

Dr. Jason Harris is a pediatric infectious disease specialist at Massachusetts General Hospital in Boston. He is the lead author of a study that looked at cholera patients in Bangladesh to try to better understand their immune response to the infection. His team began their study in 2000.

HARRIS: "It was done at a wonderful institution, called the International Center for Diarrheal Disease Research in Bangladesh, which is known as ICDDR,B, for short. Bangladesh itself is one of the places in the world where cholera is at its most common, and so the ICDDR,B takes care of over 100,000 patients a year with diarrhea, probably about 20,000 of them on average have cholera."

LaCAPRA: The research team collected blood samples from 361 cholera patients who came to the center for treatment between 2001 and 2006.

HARRIS: "We measured their immune response over three weeks."

LaCAPRA: Fifty-three cholera patients in the study also had intestinal parasites.

HARRIS: "Those patients went on to develop weak immune responses to the cholera toxin."

LaCAPRA: Specifically, compared to other cholera patients, those with intestinal parasites produced about half as much of a particular antibody, called IgA.

HARRIS: "And this antibody we think is very important for protecting against intestinal infections."

LaCAPRA: In other words, since cholera patients who have intestinal parasites produce fewer protective antibodies against cholera bacteria, they could be more vulnerable to getting re-infected.

Harris says his findings could also help explain why cholera vaccines that have looked very promising in medical trials in the U.S. and Europe haven't worked very well in developing countries.

HARRIS: "This might be part of the explanation for that, that there's high rates of parasitic infection in countries where cholera is common."

LaCAPRA: His work also points to a way to improve the effectiveness of existing cholera vaccines.

HARRIS: "This study suggests that efforts to treat intestinal parasites, perhaps to treat them before vaccinating, may improve the response to cholera vaccines and may improve the chance of developing a healthy immune response that makes the vaccines more effective."

LaCAPRA: But, Harris says, as the current epidemic in Zimbabwe shows, we still have a long way to go in controlling this widespread disease. His research is published in the journal PLoS Neglected Tropical Diseases. I'm Véronique LaCapra.

Diabetes book offers expert guidance from Mayo Clinic

Diabetes is a life-threatening class of diseases in which the body fails to regulate sugar levels in the blood. It is one of the nation's - and the world's - costliest chronic illnesses.

The World Health Organization estimates that more than 180 million people worldwide have diabetes, and says the number is likely to more than double by 2030.

The prestigious Mayo Clinic is out with a new book designed to help healthy people prevent diabetes and to show diabetics how to live - and thrive - with the disease. Mohamed Elshinnawi spoke with the book's medical editor and wrote our report, which is narrated by Rob Sivak.

SIVAK: The Mayo Clinic's Essential Diabetes Book is a comprehensive and up-to-date manual on diabetes, intended for the general public. It sets out to educate people and to explode myths - such as the one that diabetes is caused by eating too much sugar. In fact, we learn, while diabetes is associated with obesity, its root causes are varied and complex.

COLLAZO-CLAVELL: "Probably the number one cause of diabetes becoming so common, [as well as] pre-diabetes, is definitely our lifestyle."

SIVAK: Dr. Maria Collazo-Clavell is the book's medical editor and a specialist in the Mayo Clinic's division of endocrinology, metabolism, and diabetes.

COLLAZO-CLAVELL: "Definitely the fact that most of us are heavier than [we have] been in the past, and less active. So definitely being conscientious about our eating habits, our weight, and our activity become very important to prevent type-2 diabetes particularly."

SIVAK: Collazo-Clavell explains that race is also a major risk factor with this disease. Blacks and Hispanics are about one-and-a-half times more likely than white Americans to develop type-2, or adult diabetes. But she notes that Type 1 diabetes, better known as juvenile diabetes, is more common among white Americans than black- and Hispanic-Americans.

Collazo-Clavell says it can be challenging for diabetics and those at risk for the disease to eat healthful meals and exercise regularly in the midst of busy schedules. But the Mayo Clinic specialist says these are essential goals:

COLLAZO-CLAVELL: "Whatever physical activity someone can do, it's worth doing. What often happens is that people have so many other limitations that keep them from adhering to this perfect, beautiful 30-45 minute program that they are supposed to do four to five times per week. But what we have learned is that short bouts of activity are just as helpful as prolonged bouts of activity."

SIVAK: Collazo-Clavell also cautions people with diabetes to be diligent about their management and treatment regimens, because long-term diabetes complications can be irreversible.

COLLAZO-CLAVELL: "It is never too late to start caring for your health and protecting your health, but the sooner somebody does it, the better a life they will lead because diabetes will not limit their lives. Their risk of having an amputation, their risk of having to go on dialysis, their risk of developing blindness will be significantly lower so they can continue to enjoy their lives."

With President Obama's decision to allow federal funding of embryonic stem cell research, Collazo-Clavell says she's optimistic about the future of managing and curing diabetes. But she says diabetics shouldn't expect any medical breakthroughs soon.

Dr. Maria Collazo-Clavell hopes the Mayo Clinic's new Essential Diabetes Book will be both a helpful guide for diabetics and a wake-up call to the general public about a serious and increasingly common disease. For Our World, I'm Rob Sivak in Washington.

Microsoft pulls plug on Encarta encyclopedia

From the world of online information ... Microsoft announced this week it is discontinuing its digital Encarta encyclopedia later this year.

Encarta began in the early 1990s on compact disc. It later migrated to the Web and expanded to include various language editions.

Microsoft said its decision to discontinue the encyclopedia was made because, quote, "People today seek and consume information in considerably different ways than in years past."

But New York Times blogger Noam Cohen said Encarta just couldn't compete with the free online encyclopedia Wikipedia. Many have raised questions about Wikipedia's accuracy. It's written by users. But despite that — or maybe because of that, and its up-to-the-minute timeliness and broad scope — Wikipedia has become hugely popular.

Website of the Week features user-written travel guide

And speaking of wikis, it's time again for our Website of the Week, when we showcase interesting and innovative online destinations.

When I was a student, I hitchhiked through Europe one summer with a thick travel guide in my backpack. So 20th century. Today's traveler often carries a laptop or web-enabled mobile phone, and the info may come from online sources like Lonely Planet or our Website of the Week.

CONVER: " is a project to create a free and complete, up-to-date reliable world travel guide. It's built in collaboration by the community."

Brent Conver oversees travel sites, including Wikitravel, at parent company Internet Brands. If you've ever used Wikipedia, you'll feel right at home at

CONVER: "So it's going to look very similar. The articles are very in-depth, and they're all kind of in blog format, so you kind of read down and you don't have to click through a bunch of different pages to get there. It's all in one, very consistent location. So it's actually very easy for the traveler on the road to go through."

Like other wikis, Wikitravel is written by its users — 30,000 of them, Conver says, who have written more than 20,000 articles in English and almost 20 other languages. The contributors are mostly visitors to the places they're writing about, but you also get the local perspective of people who live there.

Brent Conver says that because of its large number of contributors, Wikitravel can be more up-to-date than conventional travel guides. And he notes that the anyone-can-edit format also improves accuracy.

CONVER: "We have a really vibrant community that spends a lot of time editing other people's edits, making sure that we're having the most accurate, up-to-date information available on the Web."

Like any wiki website, Wikitravel isn't going to be 100 percent accurate all the time - but then, neither are conventional travel guides. Check it out at, or get the link to this and more than 200 other Websites of the Week from our site,

MUSIC: J.J. Keki and Family — "Were Baba Wefe" (Prayer For Travelers)

It's VOA's science and technology magazine, Our World. I'm Art Chimes in Washington.

Advocates call to put agriculture on climate agenda

Policy-makers from 175 countries are meeting in Bonn to lay the groundwork for an agreement to succeed the Kyoto Protocol. That United Nations-sponsored climate change treaty expires in 2012, and negotiations on a replacement will conclude in Copenhagen in December. Agriculture could be an important part of the climate-change agenda. VOA's Rosanne Skirble reports.

SKIRBLE: As negotiators draft language on how nations can reduce climate-changing industrial emissions and mitigate global warming, Gerald Nelson says one word that's missing is agriculture. It was absent from the Kyoto agreement, and the research fellow with the International Food Policy Research Institute, IFPRI, doesn't want that mistake repeated.

NELSON: "As countries did their national inventories and more information became available, it was clear that deforestation was a serious source of carbon emission, but that agriculture was also important [for CO2] and nitrous oxide and methane from livestock and irrigated rice systems in particular."

SKIRBLE: Along with urbanization and the loss of forests, agriculture contributes more than thirty percent of the greenhouse-gas emissions responsible for global climate change. Nelson says the relative emissions differ dramatically by region.

NELSON: "If we look at the role of the developing countries, agriculture is 60 percent of the total [30 percent overall] and essentially 100 percent of the forest and land use changes come from the developing countries."

SKIRBLE: Scientists predict a warmer climate will dramatically intensify the challenges farmers already face from drought, floods, pest infestations and disease. Mark Rosegrant, IFPRI's director of Environment and Production Technology, says that intensification will be most evident in developing countries, where people are already hardest hit by poverty and hunger.

ROSEGRANT: "For example, we are finding that rain-fed maize production is likely to decline by 17 percent globally and irrigated rice fields could decline by 20 percent globally. We are projecting that we will see higher food prices due to climate change, so that not only do we have a lower production, but high prices will affect poor consumers negatively, reducing food security and well-being."

SKIRBLE: Farmers will have to adapt to the impending climate change regardless of efforts to curb greenhouse gases. But IFPRI's Gerald Nelson says new technology and management practices can both reduce emissions and lessen the risks to small farmers.

NELSON: "How do we do that? Change crop mixes, use cultivation systems that leave residues, shift land use from annual crops to perennial crops or to pasture or to agriforestry."

SKIRBLE: IFPRI's Gerald Nelson adds that the new climate negotiations offer an opportunity to both mitigate the effects of global warming and, by supporting the world's food producers, to help millions of the world's poor win their fight against hunger and poverty. A detailed outline of the IFPRI's Agenda for Negotiation in Copenhagen is posted on the website.

NASA showcases Orion spacecraft in Washington

The American public is getting its first look at the new Orion spacecraft that will be taking humans back to the moon by the year 2020. As VOA's Julia Ritchey reports, the Orion is part of a new fleet of vehicles that will make 21st century space exploration possible.

RITCHIE: Weighing in at more than 8,000 kilograms, the Orion crew exploration vehicle is targeted to begin carrying humans to the International Space Station in 2015 and then to the moon in 2020, fifty years after man first stepped foot on its surface.

The National Aeronautics and Space Administration Monday displayed a full scale model of Orion on the National Mall in downtown Washington.

Don Pearson is the project manager of NASA's Post-Landing Orion Recovery project. His team is in charge of testing Orion's ability to launch in all weather conditions and rescuing the crew when it lands back in the ocean.

PEARSON: "What we're trying to do is demonstrate that we can recover this capsule when the waves are up near 12 foot [4 meters] in height and winds on the order of 35-40 knots. If we can do that, then we'll have a fairly good launch probability."

RITCHIE: Orion is nearly double the size of its predecessor, the Apollo, allowing it to transport up to six crew members to the Space Station and four to the moon.

Don Pearson says he hopes showcasing Orion and talking about the lunar mission will reenergize a new generation of children to become interested in science and math.

PEARSON: "The first time we launched the space shuttle, people were pretty excited about it. Taking an airplane, turning it on its side, and launching it. And people looked at that and said, 'Wow, that's cool.' Well we're hoping the same kind of thing will happen here."

RITCHIE: Pearson says the ultimate goal of putting astronauts back on the moon will be to get them ready to go to Mars, a three year round trip journey . Julia Ritchie, VOA News, Washington

Space station prepares for expanded crew

There are six astronauts on board the International Space Station this week, as happens when incoming and outgoing crews overlap. In a video press conference on Wednesday, reporters on Earth got to ask a few questions, and we've got a couple of their answers for you.

The crew members in Expedition 19, who arrived on board a Soyuz spacecraft in late March, included flight engineer Michael Barratt. He's also a medical doctor and editor of a textbook on space medicine. So it's perhaps no surprise that on his first space flight he was asked how he has reacted to the near-zero gravity on the space station.

BARRATT: "I found some things easier than I expected, such as forming ... the 3D spatial awareness has not proven to be that difficult. But at the same time that doesn't mean I fly very gracefully as yet. But in general - (laughs) I'm getting confirmation on that! But in general, adaptation to zero gravity, it follows what we know, and I think it's a great confirmation that what we wrote in our book is more or less right."

Starting later this year, the space station will have a permanent crew of six, not just when the three-person crews overlap. Michael Fincke, who has commanded the space station for the past almost six months, says the station is ready to accommodate the larger crews.

"All the little things that nagged us in the past couple of weeks, we fixed with the last shuttle flight. We have full power. We're fully configured inside. And even our water processing system is up to full speed."

"Water processing" as in recycling urine for drinking water. Just another glamorous aspect of space flight.